Activity is an essential but often forgotten part of a diabetes management program.

For all people living with diabetes, physical activity is essential for maintaining good health. It's an important component in managing blood glucose, and if incorporated properly, may actually lessen the need for diabetes medications, or allow you to modify the insulin you take. Some people even call exercise the "invisible insulin" because of the way it can help your body.

Moving your muscles through activities such as walking, swimming, dancing or jogging stimulates a chemical reaction inside your muscle cells. This reaction actually makes your cells more sensitive to the insulin that is circulating around them. A healthy activity can be as simple as walking or gardening. Or, you can play a sport or work out at the gym. When you’re active, your muscle cells use blood glucose for energy. That’s why it helps to control blood glucose. If you are in control of your diabetes and have an unexpected blood glucose “spike”—for example, if you ate too much carbohydrate at a meal—then a brisk walk can help you get back down to where you should be.

Once the circulating blood glucose is used up, the body can turn to its stored fat for fuel (which is why exercise helps with weight loss). And activity helps with general health—your blood pressure, for example. There are many good reasons to be as active as possible.

Caution
People living with diabetes do need to watch for some side effects of exercise. If you are on certain diabetes medications or insulin, your blood glucose can actually drop too low if you’re not careful. The situation where blood glucose levels go too low is called hypoglycemia. You can become weak and feel shaky. In extreme cases, low blood glucose can even lead to unconsciousness or a coma.

For this reason, your doctor might recommend that you measure your blood glucose before exercising, so you know the point you’re starting from. You need just the right amount of blood glucose to get you through the activity. It’s also a good idea to have a carbohydrate snack with you when you exercise—some candies, glucose tablets, dried fruit—just in case you do start to go low.

Exercise can also result in high blood glucose if you are in poor control of your diabetes. For example, if you have Type 1 diabetes and your glucose is over 250 mg/dL, check for ketones and correct your high blood glucose before beginning the exercise. If you don’t do this, your blood glucose may go even higher. If you have Type 2 diabetes, which leads to chronically high blood glucose, then the stress of exercise can also push you higher, rather than lower. You don’t need to check for ketones, but you still need to be cautious with your exercise. Talk to your doctor about how to monitor your blood glucose around exercise.

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